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Contact Information

CROCKETT SENIOR CARE, LLC
200 W STATE HWY 6
SUITE 612
WACO, TX76712
 Phone: 254-399-6788
 Fax: 254-399-6766
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for CROCKETT SENIOR CARE, LLC

NPI Number 1063858298
LBN Legal business name CROCKETT SENIOR CARE, LLC
Authorized official JACK COOK - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/15/2013
Last updated 04/14/2015 - About 11 years ago
Identifiers
TX Medicaid 001021232
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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